Dilated cardiomyopathy as a clinical syndrome: experience with nosological diagnosis with biopsy and treatment approaches
- Authors: Blagova O.V.1, Nedostup AV1, Kogan EA1, Dzemeshkevich SL2, Frolova Y.V2, Sedov VP1, Gagarina NV1, Sulimov VA1, Abugov SA2, Zaklyaz'minskaya EV2, Donnikov AE3, Kadochnikova VV3, Kupriyanova AG4, Zaydenov VA4, Beletskaya LV4, Blagova OV5, Nedostup AV5, Kogan EA5, Dzemeshkevich SL6, Frolova Y.V6, Sedov VP5, Gagarina NV5, Sulimov VA5, Abugov SA6, Zaklyazminskaya EV6, Donnikov AE7, Kadochnikova VV7, Kupriyanova AG8, Zaidenov VA8, Beletskaya LV8
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Affiliations:
- ГОУ ВПО Первый Московский государственный медицинский университет им. И. М. Сеченова
- Российский научный центр хирургии им. акад. Б. В. Петровского РАМН
- Компания "ДНК-технология", Москва
- ФНЦ трансплантологии и искусственных органов им. акад. В. И. Шумакова
- I.M. Sechenov State Medical University, Moscow
- B.V. Petrovsky Russian Research Surgical Center, RAMS, Moscow
- "DNA-technology" company, Moscow
- V.I. Shumakov Research Center for Transplantology and Artificial Organs Center
- Issue: Vol 83, No 9 (2011)
- Pages: 41-48
- Section: Editorial
- URL: https://journals.rcsi.science/0040-3660/article/view/30915
- ID: 30915
Cite item
Full Text
Abstract
Material and methods. The trial enrolled 62 patients (23 females) with DCMP syndrome (end diastolic left ventricular size > 5.5 cm, ejection fraction < 55%). Mean age of the patients was 46.0±12.8 years. The examination included diagnosis of viral infections (Herpes virus, parvovirus B19), measurement of anticardial antibodies titer, 99Tc-MIBI single photon emission computed tomography of the myocardium, multislice computed tomography, MRT of the heart, coronarography, morphological study of the myocardium (n = 20) with application of polymerase chain reaction (PCR) for H.simplex viruses of types 1, 2 and 6, herpes zoster, Epstein-Barr, cytomegalovirus, parvovirus B-19, adenoviruses. The control group (20 operated patients with valvular heart disease and coronary heart disease) was examined for viral genome in the blood and myocardium.
Results. Complex examination of DCMP patients showed the following distribution by nosological entuities: myocarditis (n = 41, 66.1%) including virus-positive (n = 14), primary DCMP (n = 16, 25.9%) including with non-compact myocarditis (NCM) in 3, with debute at delivery of the child - in 3. Arrhythmogenic right ventricular dysplasia combined with viral myocarditis (n = 2), genetic myopathy (n = 1) and Takayasu disease (n = 1) combined with NCM, isolated NCM (n = 1) were diagnosed in the rest cases. Morphological investigation of the myocardium was made in 20 patients: diagnosis of myocarditis and primary DCMP were made in 70% (including in 2 patients with CHD) and 20%. Detection of viral genome was 20 and 15% in the study and control group, respectively, in the myocardium - in 57.9 (test for parvovirus B19 was not made in 26%) and 65.0% (complete diagnosis).All the virus-positive patients with DCMP were diagnosed to have signs of active/borderline myocarditis. Diagnostic criteria and poor prognosis factors were defined.
Conclusion. The nosological diagnosis of DCMP was made in all the examinees basing on the complex of clinical, case history and device evidence. The diagnosis was morphologically verified in 33.9% patients. Treatment approaches are developed.
About the authors
Ol'ga Vladimirovna Blagova
ГОУ ВПО Первый Московский государственный медицинский университет им. И. М. Сеченова
Email: blagovao@mail.ru
канд. мед. наук, доц. каф. факультетской терапии № 1 лечебного фак-та Первого МГМУ им. И. М. Сеченова, тел.: 8-499-248-62-22; ГОУ ВПО Первый Московский государственный медицинский университет им. И. М. Сеченова
A V Nedostup
ГОУ ВПО Первый Московский государственный медицинский университет им. И. М. СеченоваГОУ ВПО Первый Московский государственный медицинский университет им. И. М. Сеченова
E A Kogan
ГОУ ВПО Первый Московский государственный медицинский университет им. И. М. СеченоваГОУ ВПО Первый Московский государственный медицинский университет им. И. М. Сеченова
S L Dzemeshkevich
Российский научный центр хирургии им. акад. Б. В. Петровского РАМНРоссийский научный центр хирургии им. акад. Б. В. Петровского РАМН
Yu V Frolova
Российский научный центр хирургии им. акад. Б. В. Петровского РАМНРоссийский научный центр хирургии им. акад. Б. В. Петровского РАМН
V P Sedov
ГОУ ВПО Первый Московский государственный медицинский университет им. И. М. СеченоваГОУ ВПО Первый Московский государственный медицинский университет им. И. М. Сеченова
N V Gagarina
ГОУ ВПО Первый Московский государственный медицинский университет им. И. М. СеченоваГОУ ВПО Первый Московский государственный медицинский университет им. И. М. Сеченова
V A Sulimov
ГОУ ВПО Первый Московский государственный медицинский университет им. И. М. СеченоваГОУ ВПО Первый Московский государственный медицинский университет им. И. М. Сеченова
S A Abugov
Российский научный центр хирургии им. акад. Б. В. Петровского РАМНРоссийский научный центр хирургии им. акад. Б. В. Петровского РАМН
E V Zaklyaz'minskaya
Российский научный центр хирургии им. акад. Б. В. Петровского РАМНРоссийский научный центр хирургии им. акад. Б. В. Петровского РАМН
A E Donnikov
Компания "ДНК-технология", МоскваКомпания "ДНК-технология", Москва
V V Kadochnikova
Компания "ДНК-технология", МоскваКомпания "ДНК-технология", Москва
A G Kupriyanova
ФНЦ трансплантологии и искусственных органов им. акад. В. И. ШумаковаФНЦ трансплантологии и искусственных органов им. акад. В. И. Шумакова
V A Zaydenov
ФНЦ трансплантологии и искусственных органов им. акад. В. И. ШумаковаФНЦ трансплантологии и искусственных органов им. акад. В. И. Шумакова
L V Beletskaya
ФНЦ трансплантологии и искусственных органов им. акад. В. И. ШумаковаФНЦ трансплантологии и искусственных органов им. акад. В. И. Шумакова
O V Blagova
I.M. Sechenov State Medical University, MoscowI.M. Sechenov State Medical University, Moscow
A V Nedostup
I.M. Sechenov State Medical University, MoscowI.M. Sechenov State Medical University, Moscow
E A Kogan
I.M. Sechenov State Medical University, MoscowI.M. Sechenov State Medical University, Moscow
S L Dzemeshkevich
B.V. Petrovsky Russian Research Surgical Center, RAMS, MoscowB.V. Petrovsky Russian Research Surgical Center, RAMS, Moscow
Yu V Frolova
B.V. Petrovsky Russian Research Surgical Center, RAMS, MoscowB.V. Petrovsky Russian Research Surgical Center, RAMS, Moscow
V P Sedov
I.M. Sechenov State Medical University, MoscowI.M. Sechenov State Medical University, Moscow
N V Gagarina
I.M. Sechenov State Medical University, MoscowI.M. Sechenov State Medical University, Moscow
V A Sulimov
I.M. Sechenov State Medical University, MoscowI.M. Sechenov State Medical University, Moscow
S A Abugov
B.V. Petrovsky Russian Research Surgical Center, RAMS, MoscowB.V. Petrovsky Russian Research Surgical Center, RAMS, Moscow
E V Zaklyazminskaya
B.V. Petrovsky Russian Research Surgical Center, RAMS, MoscowB.V. Petrovsky Russian Research Surgical Center, RAMS, Moscow
A E Donnikov
"DNA-technology" company, Moscow"DNA-technology" company, Moscow
V V Kadochnikova
"DNA-technology" company, Moscow"DNA-technology" company, Moscow
A G Kupriyanova
V.I. Shumakov Research Center for Transplantology and Artificial Organs CenterV.I. Shumakov Research Center for Transplantology and Artificial Organs Center
V A Zaidenov
V.I. Shumakov Research Center for Transplantology and Artificial Organs CenterV.I. Shumakov Research Center for Transplantology and Artificial Organs Center
L V Beletskaya
V.I. Shumakov Research Center for Transplantology and Artificial Organs CenterV.I. Shumakov Research Center for Transplantology and Artificial Organs Center
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